Provider Demographics
NPI:1629887468
Name:SHULL, ORIANA JUPITER
Entity type:Individual
Prefix:
First Name:ORIANA
Middle Name:JUPITER
Last Name:SHULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ORIANA
Other - Middle Name:JUPITER
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1437 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72153-8450
Mailing Address - Country:US
Mailing Address - Phone:501-253-4441
Mailing Address - Fax:
Practice Address - Street 1:8 WILSON ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:GREENBRIER
Practice Address - State:AR
Practice Address - Zip Code:72058
Practice Address - Country:US
Practice Address - Phone:501-697-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician